Mr. Speaker, it is a pleasure to come before my colleagues on the House floor this evening to spend an hour with them talking about the new Medicare Prescription Drug part D and Medicare Modernization Act, which was passed in December 2003…
Mr. Speaker, it is a pleasure to come before my colleagues
on the House floor this evening to spend an hour with them talking about the new Medicare Prescription Drug part D and Medicare Modernization Act, which was passed in December 2003 in a bipartisan fashion by this body and signed into law by President Bush. But before we get started, I want to spend time going through a lot of the nuances of this bill and make sure that all of my colleagues, and especially, of course, if some seniors and people that are watching this body and paying attention to what we say here on this floor, it will help them better understand, and I think we will have spent a very, very beneficial hour this evening.
Before I get started, I cannot help but think about, this is October 4, the fall of the year, the most beautiful time of the year in many parts of this great Nation of ours, especially in my home State of Georgia and my 11th Congressional District in the northern part of the State. In 27 days will be one of my favorite holidays, and I am sure my colleagues would agree with me that Halloween, Halloween is always one of the most fun times of the year, especially if you have children, as I have. Now they are adults. I also now have precious grandchildren. What an exciting thing to go door to door in your neighborhood, in a safe environment, trick or treating, maybe even scaring people a little bit, scaring other kids with the costumes and the spooks and the goblins; and every now and then, if you do not get a good treat when you knock on somebody's door, some mean old, grumpy adult, you will scare them too.
But what we are seeing today in this body, maybe because it is a Presidential election year, but all of a sudden, Halloween does not seem so funny to me anymore, because what I am seeing from Members of this very body is adults scaring adults. And not just scaring adults, but scaring specific adults, and that is the great senior citizens of this country. In fact, I call these scare tactics, without putting on a costume, it is mainly just rhetoric, I call it Mediscare, Mediscare.
I am sure lots of seniors, I know they have in my district, because I have gone across the 17 counties doing well over 60 town hall meetings now with senior citizens, talking to the seniors about this new program, this good program, this good first step. But they have already been scared. They have been scared by so much of this rhetoric, as an example, that says you are going to lose your Medicare as you know it. They, the Republican majority, the President of the United States, this administration, they are going to take away Medicare as you know it. That is one Mediscare tactic.
Another: this bill is nothing but a giveaway to the pharmaceutical industry; that is all it is. The pharmaceutical industry contributes all of this money to Republican Members of the Congress to buy this bill. In fact, the pharmaceutical industry, they drew up the bill. It is nothing but a giveaway to the pharmaceutical industry.
I am going to refute some of these Mediscare tactics, and on that one I would like to right at the outset say, if that were true, when Medicare was first signed into law by a Democratic President, Lyndon Johnson, in 1965, and we had part A and part B, part A, the hospital part; part B, the doctor part. I never heard anybody say, and I am sure my colleagues never heard anybody saying that part A was nothing but a giveaway to the hospitals, or that part B was nothing but a giveaway to the doctors, because they happen to be the ones who respectively provided that care under part A and part B.
No, they did not call it a giveaway. In fact, the hospitals and the doctors, over the 38 years of the program, and it is a good program, I think it has served us well. I do not think we could get too many of my physician colleagues, and oh, by the way, I think my colleagues know that I am one of seven physician members of this body; not many of my colleagues are saying today Medicare part A or medicare part B, certainly my rural hospitals in the 11th Congressional District of Georgia, they are not saying Congressman, part A medicare has been nothing but a money tree for us, it has been wonderful, part A has been great for rural hospitals. No. They are struggling. Every day they are struggling.
So we hear all of these things and these scare tactics and telling the seniors, even now that we have this interim prescription drug discount program, because it takes a while to get the prescription drug benefit, the insurance part, and it is totally, totally optional, not required; but we will not have that ready until January of 2006. But this President and this Congress and this leadership, this Republican leadership, knew that our seniors needed relief right now. They really do. Some are trying to make these decisions about paying their utility bill or their mortgage payment; and all of a sudden, it is time to refill that prescription and they do not have the money to do it. And they are breaking pills and they are skipping pills. These seniors, those who are on fixed income, those low-income seniors who are in that bind really cannot wait until January 1 of 2006. They need relief right now.
That is what the interim prescription drug discount program is all about. It is a Godsend for them. Yet, here again, Halloween is upon us, really a Presidential election is upon us, just 3 days after Halloween. That is what it is all about. But to scare seniors, especially those needy seniors who, by just signing up for that prescription drug Medicare-approved discount card get a $600 credit each of the 2 years; a $1,200 credit toward the purchase of those much and badly, desperately needed drugs. They are being scared into not signing up, not picking up that telephone and dialing 1-800 Medicare and spending 15 to 20 minutes at most on the phone and getting that card in their hand.
These cards have been available since June 1 of this year. I am very pleased that 1.8 million currently have them of the low-income, needy seniors, and something like 4 million overall. But we need to do better, and the reason we are not doing better is simply because of this Halloween Mediscare mentality of scaring seniors into not participating.
Well, enough of that. We will get back to that maybe a little later in the hour. But let us talk a little bit about the reason that we need to have a prescription drug benefit under Medicare.
Well, it is a 38-year-old program. Medicare as we know it is a 38- year-old program. It is a 20th century health care program with no coverage for prescription drugs, none whatsoever, except certain medications that are actually administered by a physician in a doctor's office intravenously or intramuscularly to treat maybe end stage renal disease and cancer, chemotherapy. Anything else, any time the general practitioner, the family practitioner, the general internist, writes those three or four prescriptions, none of that, that is all out of pocket. And many of our seniors do not have any coverage.
They do not have an insurance program through the VA program or TRICARE or as retirees for let us say a State worker or Federal employee or maybe a generous benefit from a company they have worked for for 35, for 40 years. Many of them do not have that. They have absolutely nothing. So this program is way, way overdue. And so many other Congresses and other presidents, the Democratic majority have made promises to our seniors and talked about delivering, delivering on a promise and failed to do so. And all of the sudden this President has the courage and the wisdom and the insight and the compassion to get a tough bill through this Congress. And now, instead of getting credit for that, these Medicare tactics are trying to discredit him over that. Amazing. In fact, down right appalling.
Another scare tactic is this, and I know we all have heard it. When we debated the bill there was a lot of discussion about this, and some of the seniors organizations were very concerned about, is it possible that when we start offering a prescription drug benefit under Medicare, are many of the conditions that currently have a health retirement benefit for their employees, for their retired employees, that does include prescription drugs, are they going to be encouraged because now this Medicare Prescription Drug Part B is an optional benefit to seniors to just drop these programs?
So that is another one of the scare tactics. Yeah, do not vote for this bill because, if you do, the first thing that is going to happen is your company,
that you worked for 30, 35 years, they are going to drop you like a hot potato, as the expression goes.
Let me point out to my colleagues, and I want to call their attention to this first slide. What this slide shows is that, over the last 12 years, the number of large employers who have been offering health care for their retirees, the number that has actually begun to drop this coverage, even before we passed this bill, has been decreasing over these last 12 years. This first part of the slide shows people who are under 65 and are retired. In 1991, 88 percent of them were covered by health care that included a prescription drug benefit. In 2003, this coverage has dropped to 72 percent.
Now, this is for the people who are under 65. What happens now when they become Medicare eligible at age 65? In 1991, the percentage that were covered by their former employer was 80 percent, less than those under 65 who are not eligible for Medicare yet. And the drop off again is substantial, from 1991 to 2003, down to 61 percent.
The point of this first slide is basically to show that this is already happening, this is already happening. And it is not because of the fact that we now are offering a prescription drug benefit to these seniors who now, if they are dropped by these plans by their former employer, they have nothing. They have no coverage at all. And as part of this new Medicare modernization and prescription drug act, and I do not know exactly what the dollar amount of the estimated cost is, the Congressional Budget Office very clearly said to the Congress, it is going to cost $420 billion over 10 years. We have got another number later on that, was over $500 billion, but a significant amount of that money, something like $75 billion dollars is going to these companies, these large companies, large and small companies, to help them wrap around the Medicare prescription drug benefit so they will continue, they will continue to offer health insurance that includes prescription drugs and actually bend this curve, not make it worse, but maybe stop this normal attrition that is already occurring without the prescription drug benefit and the modernization to Medicare. This is already happening. So we are going to turn that curve around. And I sincerely believe that that will happen.
Remember at the outset when I said about some of the Medicare rhetoric, and the first one I think we mentioned was they, the Republican majority, the President, indeed, they are about to take away Medicare as you know it. And the chairman of the Committee on Ways and Means, the gentleman from California (Mr. Thomas), was quoted as saying, ``Well, we certainly hope so,'' and roundly criticized by our colleagues on the other side of the aisle.
What the chairman meant by that was quite simply, Medicare as we know it has been sorely lacking for all these years, no prescription drug benefit, part A and Part B, yes. But all of the sudden we are going to offer something that hopefully keeps seniors out of the hospital, they now have coverage for that, do they not, under Medicare part A, and out of the nursing home also under Medicare part A, but that coverage is not to infinity.
What happens is, when our seniors go into the hospital, there is a significant co-pay, and they use up their days, and then everything is out-of-pocket. They have to go into a skilled nursing home for a very limited number of days per illness, and then, everything after that is out of their pocket. And in many instances, they literally go broke in a nursing home and have to go on Medicaid and lose a lot of pride and a lot of dignity in the process. But even more importantly, as the gentleman from California (Mr. Thomas), so concisely and clearly indicated, Medicare as we know it needs improvement. And Medicare as we know it, if we do not do something to improve it and we continue to let people get terribly sick with end-stage renal disease or significant coronary blockage, and they end up in the hospital needing bypass surgery or maybe an amputation, and then possibly spend the rest of their lives in a nursing home because their high blood pressure was not treated in a timely fashion and they suffered what we refer to medically as a cerebral vascular accident but what you know as a stroke, yes, they get treated all right in the hospital and in the nursing home until their money runs out. But is that the compassionate thing to do?
That is Medicare as we know it. That is exactly what the gentleman from California (Mr. Thomas) was talking about when he said, Medicare as we know it needs to go. We need to improve upon it. And that is what we are going to do, and that is what we are doing with this interim drug discount program. And starting in January 1 of 2006, the opportunity for our seniors, the option or choice, it is not required, of course, but hopefully, just as many who signed up back in 1965. It was President Truman himself, former President Truman who voluntarily signed up for Medicare Part B in 1965; and some 95 percent, maybe more than that, of our seniors who are on Medicare, are voluntarily on Part B because it is a good program.
The taxpayers are paying 75 percent of that premium, even though it has gone up over the years, because the cost of health care has gone up. But that is formula driven. But we need to change Medicare as we know it. And that is what we are doing with this bill, this new law. And I thank God for that. And I think our seniors thank God for that, and they thank this Congress, the Members that voted for this bill, and they thank President Bush for having the courage to see this through and deliver on a promise.
When I came to the Congress in 2003, almost 2 years ago, as only one of seven physician Members on the House side, we have Dr. Frist, the majority leader on the Senate side, a lot of people told me back home, they said, especially my physician constituency, my friends that I had practiced medicine with for almost 30 years, You are going to go up to Washington and you are going to solve all of our problems, and you are going to explain to the 434 other Members, the non-physician Members how to get it done, what our needs are, what the problems are, what the problems with health care in general but for Medicare and our seniors specifically. We are counting on you. We are counting on you to make sure that everybody else understands this, and we solve the problems.
And I would say to them today, I am working on it. I am trying hard. But what I found when I arrived here is lots of folks, some physicians, many not, who have been working on health care and working to deliver a more modern 21st century health care system for our seniors; the same thing that we Members of Congress enjoy, all of our Federal employees under the Federal health employees benefit program, State employees, people indeed under the TRICARE system, enjoy, 21st century medicine. And there have been many Members in this body who have been working tirelessly for quite a few years before this Member, this physician Member arrived.
One of those is here with me tonight, and I am so proud to call her my friend and colleague. She is not a physician, but her husband is a physician. In fact, he is a retired OB-GYN just like myself. And as the chairman of the Subcommittee on Health of the Committee on Ways and Means, I am going to state that she has been invaluable to me and to all of her colleagues in sharing her knowledge, in making the most complex, arcane part of Medicare law understandable, understandable to me and to all the Members.
So it is with a great deal of pleasure that I recognize her here this evening and let her take as much time as she wants to talk a little bit more about the specifics of this bill. The gentlewoman from Connecticut (Mrs. Johnson).
Mr. Speaker, I thank the gentlewoman from Connecticut (Mrs. Johnson) very much, and if she will, I would like for her to go over that a little bit because I think there is still a lot of confusion about that, and if the gentlewoman can take a few more minutes and explain that. I know the Members would appreciate hearing from her.
Mr. Speaker, I thank the gentlewoman from Connecticut, the honorable chairman of the Subcommittee on Health of the Committee on Ways and Means. I know she has got a very busy evening, as all of her evenings here in the Congress are just jam-packed with other obligations, for her to come by tonight and help us share this time and explain, as I said earlier, you can see what I am talking about, she makes it so clear and understandable. I invite her to stay as long as she can, and if she needs to leave, I understand that, but I am very, very appreciative of her work and her expertise. I thank her so much.
What I wanted to say, just kind of in following up on some of her remarks, this is a bipartisan bill. This new Medicare Modernization and Prescription Drug Act that preserves, protects, strengthens and simplifies Medicare as we know it, that is what we are talking about, and I am proud that it was a bipartisan vote.
There were some Members on both sides of the aisle who were concerned about the bill, for different reasons, and voted against it. I think 28 of my Republican colleagues actually voted against passage of this bill, and remember what they said when they came down and spoke against the bill and in a vote of conscience voted against it? They thought that the bill was costing too much; we could not afford it. We could not afford to deliver on this promise.
Their concerns with the deficit, of course, are understandable. Their concerns with the need to continue to successfully wage this war against terrorism and to win is very understandable. So these 28 Members, my colleagues on my side of the aisle, voted no. They wanted to do it. They knew it was a good program that they felt its time had come, but yet did not think we could afford to do it. They voted no.
I think it is an accurate statement to my friends on the other side of the aisle, the Democrats who voted against the bill, most of them felt that we were not doing enough. Another one of those Medicare tactics I was talking about in this Halloween season is, the hole in the donut is too big; the hole in the donut is big enough to drive a truck through.
So they wanted to do more. In fact, the proposal that I heard from a number of Members on the other side of the aisle who voted ``no'' was, well, let us close that hole in the donut so we give better coverage to everybody, especially good coverage to those needy seniors that the gentlewoman from Connecticut was talking about.
But that bill would have cost us something like $2 trillion over a 10-year period of time. And we certainly could not afford that. Yet, for whatever reason, those who felt like we were not doing enough and we needed to do more, and those who felt like even though we were not doing enough we could not even afford that much, that was a vote of conscience on their part. And that is understandable.
But the bill did pass in a bipartisan fashion, a much wider margin, I might add, than the other body, than the Senate. But my Republican colleagues who voted ``no,'' a vote of conscience, you do not hear one single voice from my side of the aisle going around and scaring seniors and telling them do not accept a Medicare prescription drug discount card, this interim program, which is available right now. And many of those beneficiaries are eligible for that $600 credit. All they have to do is pick up the telephone, 15-minute conversation, and they have got that prescription drug discount card, which probably lowers the cost of their prescriptions maybe 20 percent, if it is a brand-name drug, possibly up to 40 percent if it is generic, in addition to the $600 per year or $1,200 over the course of the interim program.
You do not hear my friends who voted ``no,'' a fiscally conservative vote, you do not hear them telling the seniors not to sign up for those cards. But you do hear that from my colleagues on the other side of the aisle who voted ``no.'' Again, a vote of due conscience because they thought we were not doing quite enough, that we needed to do more. Wish we could. Hopefully, as the gentlewoman from Connecticut (Mrs. Johnson) said, as we go further along into this program, we will be able to do more; and we will work with our colleagues on the other side of the aisle to try to make it a program, which is already a great first start, even better as we go forward, as we can better afford to do more.
Oh no, that is not enough for them. They have to scare seniors, and they have been doing it ever since December of 2003. Not just this Halloween season, but of course the rhetoric is getting a little more heated now because not only are we getting close to Halloween but we also are getting closer to November 2, and we all know what November 2 is. So it is all about who gets the credit or, from their perspective, who gets the discredit. They want to scare the seniors enough and tell them do not even accept the prescription drug discount card, when they can get $600 a year credit in their medications and, in many instances if they are a low-income senior, will cost them nothing. Unbelievable. Unbelievable.
The gentlewoman from Connecticut was talking a little bit about the basic program, the part B, the insurance program, that will be available as a voluntary option in January 2006. For the average senior whose income is, let us say, more than $18,000 to $20,000 a year, this is what the program will cost. And I want to call my colleagues' attention to this slide.
Basically, $35 a month premium, a $250 deductible per year, and then 25 percent copay. That means the good news is Medicare and the general taxpayer, those individuals who are still out there in the workforce paying that payroll tax, cover 75 percent, up to $2,250.
Now, yes, there is a gap in coverage. This is what we refer to as the hole in the donut. And beyond that point, until the senior has spent $3,600 out of pocket, there is no coverage and the senior has to pay 100 percent. That is the part we are going to improve as time goes on. But the good news in that, the glass being half full and not half empty, is that when they reach that point, then the coverage is 95 percent insurance and 5 percent copay.
Mr. Speaker, I want my colleagues to pay attention to this next slide, just to give them an example of some of the savings that will be affected by this interim prescription drug discount program. If a senior is paying today $100 per month for prescription drugs, and believe me those who have had those town hall meetings and talked to their seniors, many of them are paying $100 a month, some are paying $500 a month and more. But let us just take $100 a month. They will have an annual savings of $773, basically reducing their annual prescription cost for drugs, for prescription drugs, by 64 percent.
Let us take another example. Let us say it is $500 a month. Let us say it is a senior, someone like myself, who has had a little heart surgery and is on four medications a month, each one of them costing $100-plus. Pretty quickly they are up to $500 a month. Well, this prescription drug plan, over a period of a year, is going to save them $2,700, reducing their annual cost by 45 percent.
Let us continue. How about $800 a month? How many have relatives, parents, or grandparents who may be on six or eight prescription drugs a month and they are paying over $800 a month? The annual savings, $5,871, some 61 percent reduction of their annual cost for prescription drugs. Simply amazing.
Mr. Speaker, I think it was the Honorable Speaker Tip O'Neill who said a few years ago ``all politics is local,'' so let me spend a few minutes talking about my district, the 11th in Georgia. I want to call my colleagues' attention to this slide.
In Georgia's Eleventh Congressional District alone, the average senior will save $1,488 off their prescription drug
costs over 18 months. Over an 18-month period of time $1,488 savings. That is not pocket change. That is certainly not pocket change for seniors, many of whom are on a fixed income. These savings represent 42 percent off of the typical senior's drug cost.
In fact, it is estimated that prescription drug savings for the State of Georgia, all the seniors in the State of Georgia will reach $186 million; $186 million. That will certainly help the bottom line in Georgia, and the bottom line especially for our needy seniors.
I also want to call attention to this next slide. This is just a typical example of what a Medicare prescription drug discount card looks like. And I guess the most important thing here, and I know we have 1.8 million seniors who have these, but we want more to take advantage, because the time is slipping away and the opportunity to get that credit that so many of them are eligible for. We do not want them to lose that opportunity. But the most important thing about this card is that it has the Medicare seal of approval. That way you know that that is the real deal. That is the card.
There will be plenty to choose from. They are available now. In fact, they have been available since June 1 of this year. It is time for our seniors to reject the Mediscare rhetoric and get these cards. Sign up for them. All you have to do is pick up that telephone and dial 1-800- Medicare, and they will walk you through the steps in 15 or 20 minutes.
Mr. Speaker, this is another slide that I am calling my colleagues' attention to; and basically what it reflects in the respective States is how many Medicare beneficiaries are there who will actually pay no more than $5 per prescription under this new Medicare Modernization Act and Prescription Drug Bill. The State that, of course, jumps off the page at me is my State. I am sure my colleagues feel the same as they look at this slide and pick out their State, whether you are from the West, the North, the East, the South, or wherever, or in the heartlands.
When I look at Georgia, the great State of Georgia, and realize that 233,000, 233,000 Georgians under this new plan, because of their income, because they are on a fixed income, maybe they are below 150 percent of the Federal poverty level, the most that they will pay on this program is $5 per prescription. That is it, $5 per prescription. That is 233,000 in the great State of Georgia.
We have some tremendous strains, of course, in the Medicare program. I mentioned at the outset how tough it is for the physicians to stay in the program, that it is not a giveaway. Part B is not a giveaway to the doctors. Fortunately, many, through compassion, are staying in the program. But it is certainly no giveaway. And for sure no giveaway to our hospitals is part A. And, parenthetically, part D, the prescription drug part, is no giveaway to the pharmaceutical industry.
But just look at this slide, my fellow colleagues. Look at this and pick out your State and see the benefit to your hospitals, especially your rural hospitals, that are struggling so badly to keep those doors open. Outside of the school system, they are probably the largest employer in your county, in your congressional district. Just look at the benefit that your State gets through the hospitals under this program.
Here again, I go right to Georgia, and that is where it is most important to me. Over $550 million worth of benefit to the hospitals, especially the rural hospitals in the State of Georgia. That is $550 million, almost half a billion dollars. This is a Godsend to these hospitals. And that is what we are doing with this Medicare and Modernization Prescription Drug Act.
Mr. Speaker, I realize we are coming to the close of our hour, which has been, I think, a good time to spend talking with my colleagues and making sure that everybody understands. We have done something very historic in this 108th Congress. We have finally delivered on a promise that was made a long time ago. Thirty-eight years is a long, long time for our seniors to wait for a prescription drug benefit to modernize this Medicare program, which is still in the 20th century.
The rest of us, those of us who are not yet quite 65, although some Members of this body are, we have a benefit plan that has an emphasis on wellness, on prevention, and making sure that catastrophic illnesses do not occur to us.
This is such an important point to remember that including a prescription drug benefit may very well, in the long term, over a 10- year period of time, result in some savings to the Medicare program. Yes, we are estimating it might cost $500 billion over 10 years, but I want my colleagues to understand that it will only cost $500 billion over 10 years if it does not work. Because I would suggest that if it does work, and I sincerely believe as the President believes in this compassionate effort to finally deliver that we are going to reduce the cost of Medicare that we spend on part A, the hospital part, we are going to keep people out of the hospital. We are going to reduce the cost of part B, the part of Medicare that we spend on physician reimbursement because we are not going to be doing as much open heart surgery. We are not going to be doing as much renal dialysis and kidney transplants. We are not going to have as many people in the nursing homes for the rest of their lives who are trying to recover from a CVA, or, as you know it, a stroke, because these seniors will be able to control that high blood pressure that heretofore they could not. They knew they had it but they could not take their medication, and the only benefit they get is when a catastrophe has occurred.
I thank my colleagues for giving me an opportunity to talk to them tonight about this great program that is going to only get better. I think it is time to stop scaring our seniors. We have got 27 days before Halloween. We have got about 30 days before our elections. Let us take the politics out of this. Let us not try to ride our reelection train on the back of our seniors by scaring them over this program. It is unconscionable to do that. They deserve so much better. And you are better. I know that.
We get awfully partisan up here sometimes, but when we talk out in the halls or we realize that we are all basically the same, we have got families, we have got children, we have got grandchildren, we have got seniors in our district, let us all work toward the betterment of them through this program and quit scaring our seniors. Beyond this Halloween and this election and going forward in the 109th Congress, we will make this program even better than it is now.